Herpangina is a common viral illness that primarily affects young children, causing uncomfortable symptoms in the mouth and throat. This infection is typically caused by a group of viruses known as enteroviruses, most often the Coxsackievirus A. Because herpangina is viral in nature, the treatment approach is focused entirely on supportive care to manage symptoms until the body’s immune system clears the infection. Understanding how to manage the discomfort and recognizing when professional medical intervention is necessary are the primary goals of care.
Identifying Herpangina Symptoms
The illness begins abruptly with a sudden, high fever, often exceeding 102°F, accompanied by a sore throat and painful swallowing. The distinctive feature of herpangina is the appearance of small, painful lesions in the back of the mouth one to two days after the fever starts.
These characteristic sores typically present as small (one to five millimeters), grayish-white blisters or ulcers surrounded by a red border. They are consistently found on the soft palate, the tonsils, and the back wall of the throat. Unlike other mouth sores, these lesions are rarely found on the gums or the tongue. The combination of a high fever and these specific throat lesions helps distinguish herpangina from other common childhood infections.
Immediate Home Care and Symptom Relief
Because herpangina is viral, treatment centers on alleviating discomfort while the infection runs its course. Pain management is a top priority because the throat ulcers make eating and drinking difficult. Over-the-counter medications like acetaminophen or ibuprofen can reduce both the fever and the throat pain, though aspirin should not be given to children with viral illnesses due to the risk of Reye’s syndrome.
Maintaining adequate hydration is crucial, as painful swallowing can lead to refusal of fluids and dehydration. Encourage the patient to take small, frequent sips of cool liquids, such as water, diluted sports drinks, or milk products. Cold items like popsicles, sherbet, and ice cream are especially soothing because they provide hydration and temporary localized pain relief. Avoid acidic liquids like fruit juices, as well as spicy, hot, or salty foods, which can irritate the sensitive mouth sores.
For additional relief, topical anesthetics in the form of sprays, gels, or lozenges (for older children and adults who can use them safely) may numb the throat area temporarily before meals. Gargling with warm salt water can also help soothe inflammation. Keeping the patient well-rested supports the immune system’s effort to fight the virus, which typically resolves on its own within seven to ten days.
Preventing Transmission
Herpangina is highly contagious and spreads primarily through the fecal-oral route, but also through respiratory droplets from coughing or sneezing and contact with contaminated surfaces. The virus can be shed in stool for several weeks, meaning the patient remains contagious even after the symptoms have completely resolved. Rigorous handwashing is the most effective measure for preventing the spread, especially after using the toilet or changing diapers.
Caregivers should frequently clean and disinfect high-touch surfaces, toys, and shared items to minimize environmental contamination. Infected individuals should be kept home from school, daycare, or work until the fever has completely subsided and they are feeling well enough to return. Covering the mouth and nose when coughing or sneezing, followed immediately by handwashing, limits droplet transmission.
Knowing When to Seek Medical Attention
While herpangina is usually self-limiting, certain warning signs indicate a need for medical consultation. Dehydration is the most common potential complication, so watch closely for signs such as significantly decreased urination, a lack of tears when crying, a dry mouth, or excessive lethargy. If the patient is struggling to swallow fluids and shows these symptoms, medical intervention may be needed to restore hydration.
Medical attention is warranted if the high fever persists for more than three days or cannot be managed effectively with over-the-counter medications. Though rare, complications like meningitis can occur with enteroviral infections, so seek immediate care if the patient develops a severe headache, neck stiffness, confusion, or a seizure. If the mouth sores or sore throat worsen instead of improving after several days, or if the illness does not resolve within the expected seven to ten-day period, consulting a healthcare provider is necessary.